Doctors, scientists and tech leaders take stock after passage of ‘reasonableness’ law

American physicians and German research institutes offer moral support as Israeli healthcare workers weigh whether to stay and fight for scientific freedom or relocate

Renee Ghert-Zand is the health reporter and a feature writer for The Times of Israel.

Doctors demonstrate against the judicial overhaul in Tel Aviv on July 18, 2023. (Jack Guez/AFP)
Doctors demonstrate against the judicial overhaul in Tel Aviv on July 18, 2023. (Jack Guez/AFP)

Leaders from Israel’s healthcare, scientific and health tech community have vowed to keep fighting the government’s judicial overhaul following the passage of the first major bill this week.

The Israelis are joined by longstanding research and professional partners from outside the country who warn of possible dangers to Israeli academic freedom and important international scientific collaborations.

The law prevents courts from using the test of “reasonableness” in evaluating decisions made by the cabinet and ministers.

Among the non-Israelis who are deeply troubled are American Jewish physicians who have expressed support for their Israeli counterparts, as well as German universities and science organizations that issued a joint statement of concern in light of the damage that could be done to “decades of inspiring intellectual exchange” and a “special relationship” with Israel.

Meanwhile, Israel’s 8400 – The Health Network, a non-profit organization established in 2017 to create a coordinated and thriving health tech ecosystem in the country, issued a public letter on July 25 expressing “deep support for the pro-democracy movement and its leaders.”

The letter titled, “In Support of Actions to Defend Israeli Democracy,” was signed by some 120 of the organization’s 320 members from the top echelons of Israeli academia, biotech and med-tech entrepreneurship, healthcare, government and venture capital.

“We commend and reinforce the efforts of the hundreds of thousands of protesters fighting to safeguard Israel’s democracy, and the civic leaders who have stepped up and devoted themselves to lead this crucial struggle,” it said. “We are determined and committed to continue to fight for a democratic Israel. The road ahead is long, but we are convinced that our country’s core values of equality, freedom, and human rights will prevail.”

Endoron CEO Ronit Harpaz speaks at a demonstration in Ramat Hasharon, February 25, 2023. (Courtesy)

In it for the long run

8400 members have actively opposed the government’s judicial overhaul plans from the beginning. The organization’s leaders and members have issued statements, participated in protests around the country, and testified at the Knesset’s Constitution, Law and Justice Committee as the “reasonableness” bill was formulated and debated.

Ronit Harpaz, co-founder and CEO of Endoron, a company that developed an endograft fastening solution for patients undergoing abdominal aortic aneurysm repair, told The Times of Israel in March that she brought the latest data to illustrate the severe dangers the reforms pose to the biotech and med-tech industries.

“We felt there was absolutely no listening. I sat opposite [committee chair Simcha] Rothman. I screamed my heart out and nobody listened… We brought so much data, all the latest details… but they just mocked us. They called me privileged and told me I was wasting my time and my company’s time,” she said.

8400 CEO Daphna Murvitz (Courtesy of 8400)

As early as February, 8400 warned of damage being done by the “reasonableness” legislation.

“As a volunteer organization aimed at advancing and developing health technologies in Israel, and turning them into local and international economic growth engines, we are already aware of worrying signs in terms of companies moving intellectual property abroad and funders hesitating about making further investments in Israel,” the organization said in an official statement.

Now that the “reasonableness” law has passed, 8400 co-founder and CEO Daphna Murvitz, told The Times of Israel that she is certain the recent hits to Israel’s credit rating and warnings by Moody’s, Morgan Stanley and Citibank, the health tech industry will feel the negative impact of reduced investment even more than hi-tech.

“We are still a growing industry and therefore more vulnerable,” Murvitz said.

Israeli doctors look to leave, Americans show solidarity

Murvitz has cautioned about the non-theoretical potential for a major brain drain.

An emergency Zoom meeting took place on the evening of July 26 for the 3,000 members of a social media group of Israeli doctors interested in potentially relocating outside the country. Health Ministry Director-General Moshe Bar Siman Tov, scientific institutions, hospitals and HMOs joined the meeting to reassure the physicians and convince them to stay in Israel.

Several thousand doctors pack into Jerusalem’s International Convention Center for a Israel Medical Association-organized rally protesting the government’s judicial overhaul plans. July 23, 2023. (Renee Ghert-Zand/Times of Israel)

In its more recent letter, 8400 particularly praised its partner, the Israeli Medical Association, which has been the only labor organization so far to strike in resistance to government actions.

The IMA staged a two-hour “warning strike” on July 19, followed by a rally of thousands of doctors in Jerusalem on Sunday. After the law was passed, the IMA called for a day-long strike Tuesday that shut down much of the healthcare system. However, the work stoppage was curtailed in the late afternoon when the Bat Yam Labor Court accepted Health Minister Moshe Arbel’s request for an injunction to end what he termed, “a last-minute wildcat strike that will unjustly hurt thousands of patients.”

IMA chair Zion Hagay said he was disappointed with the ruling, but promised his organization would fight on.

“We have a long struggle ahead of us, and our declaration this week of a labor dispute will give us more tools later on, including the option of declaring a general strike — which is different from a protest strike on which the court ruled,” he argued.

Israel Medical Association chair Zion Hagay (Screenshot from YouTube; used in accordance with Clause 27a of the Copyright Law)

Fifty-two Jewish and/or Israeli physicians living and practicing in the United States signed a July 20 letter addressed to Prof. Hagay. Among the signatories are 16 heads of hospital departments and medical school deans, including those from Yale, Harvard, the University of Chicago, New York University and the University of Rochester.

In the letter, the American medical professionals expressed their solidarity with the IMA for “taking action to protect patients, physicians, and the healthcare system…We understand how difficult the decision is to strike, we also trust that you ensure that patient safety…is not affected.

“You have our support in this most difficult time. Israel has a healthcare system that is admired and appreciated all over the world, and we support your efforts to keep it that way,” the letter concluded.

Leading German scientific institutions take a stand

Murvitz told The Times of Israel that damage to global collaborations is among her greatest concerns.

“We call on our Israeli partners and friends in the health tech ecosystem overseas to take action in helping defend Israeli democracy to minimize the already apparent damage to Israel’s health tech,” she said.

“We are also working to inspire our partners abroad, to continue to collaborate with Israeli scientists and organizations as well as investors, startups and companies, so that our health tech can continue to innovate and develop breakthrough technologies that directly accelerate global cure,” she continued.

The Israeli judicial overhaul is reverberating in Germany, where six member organizations of the prestigious Alliance of Science Organizations in Germany (Max Planck Society, Alexander von Humboldt Foundation, Fraunhofer-Gesellschaft, German National Academy of Sciences Leopoldina, Helmholtz Association and German Science and Humanities Council) issued a joint statement on “Freedom and Autonomy of Science and Research in Israel.”

Since the statement was issued on July 20, the Free University of Berlin, University of Potsdam and German U15 (an association of 15 major research-intensive and leading medical universities in Germany) also joined as signatories.

The statement read: “The current [Israeli] judicial reform plans endanger academic freedom and may greatly restrict our joint scientific and innovative potential. We firmly believe that freedom of research and autonomy of academic institutions are essential for the continued prosperity of societies in Israel, Germany, and worldwide.”

Prof. Patrick Cramer, president of the Max Planck Society. (Courtesy)

According to Max Planck Society President Prof. Patrick Cramer, discussions about issuing a statement had been underway for several months, and its issuance days before the Knesset vote was “just in time.”

“We wanted to show solidarity with our Israeli colleagues, with our friends we have in Israel, and also leading scientists were asking for support or that we raise our opinion,” Cramer said.

‘Reasonableness’ already put to the test

The legal concept of “reasonableness” is not merely theoretical when it comes to the German-Israeli scientific relationship. In 2018, then-science and technology minister Ofer Akunis blocked the appointment of Ben-Gurion University brain researcher Prof. Yael Amitai to the scientific advisory board of the German Israeli Foundation because she had signed a 2005 petition calling on soldiers to refuse to serve in the West Bank.

Akunis refused to heed advice from the attorney general, and eventually the Supreme Court instructed Akunis to reconsider, stating that his refusal to appoint Amitai based on her signature of the petition was “unreasonable.” Ultimately, Amitai was appointed by Akunis’s successor Izhar Shay.

Professor Yael Amitai speaks on Channel 13 news in an undated video (Screen grab/Channel 13)

In speaking with The Times of Israel from his office in Munich, Cramer emphasized the importance of free science for the sake of the future. He said that Israel, a small yet global powerhouse in research and innovation, was an essential partner and has been so since the first German scientific delegation to Israel led by Max Planck Society president Otto Hahn visited the Weizmann Institute in 1959.

“Israelis are the ones to work with because they collaborate and exchange ideas. They also exchange postdocs and PhD students. This exchange should continue. We don’t want to see an Israeli brain drain…but scientists need the best environment for their work and total freedom,” he said.

Cramer expressed hope that the Israeli coalition and opposition will reach a compromise on judicial reform and did not venture to say what might happen to German-Israeli scientific ties should the government proceed with its overhaul plans.

In the meantime, PhD students and post-doctorates will continue participating in exchange programs as everyone waits anxiously to see how things develop.

“There is a  strong wish from both sides, that we can continue to collaborate on the highest level, as we have in the past,” said Cramer.

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